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General NPI Number Information
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NPI Number | 1730445537
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Entity Type | Individual
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Provider Name | STEVEN CLARENCE CRIDER RPH
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Gender | Male
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Dates
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Enumeration Date | 04/05/2012
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Last Update Date | 04/05/2012
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Provider Practice Location Address
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Address Line | 3740 MARKET ST
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City | SALEM
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State | OR
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Zip | 97301
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Country | US
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Telephone | 503-580-6530
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Fax | 503-945-0844
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Provider Business Mailing Address
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Address Line | 3116 METOLIUS DR
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City | EUGENE
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State | OR
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Zip | 97408
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Country | US
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Telephone | 503-580-6530
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH 000136
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH-001475
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License Number State | OR
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